左膈下脂肪浸润:急性胰腺炎一种有价值的CT征象

目的：探索左膈下脂肪浸润（left subphrenic fat infiltration，LSFI）是否为急性胰腺炎的1种CT表达及其形态学特征和出现率。方法：回顾性分析188例连续性急性胰腺炎病例的CT资料，观察LSTI的密度、厚度及其CT表现特征。同时对照观察了正常腹部50例及胸、腹腔积液各30例左膈下区域的CT表现。结果：LSFI出现率为40.96%。表现为左侧肾上腺上方、左膈肌下表面前方呈软组织密度浸润或局限性的新月形水肿、浸润带，其前方存在或不存在1层正常脂肪组织投影；LSFI的厚度为3-50mm，中位数厚度为8mm。本组资料对照组110例中，仅1例出现相似征象。结论：LSFI是急性胰腺炎CT表现中的1个新征象，随急性胰腺炎病情的转归而变化。大部分最终可以吸收消散，小部分则表现为慢性机化过程。

Left subphrenic fat infiltration:a possible significant sign on CT images in acute pancreatitis

Objective To study whether the left subphrenic fat infiltration (LSFI) is a sign of acute pancreatitis (AP) on CT images, and to observe its morphology and incidence. Methods CT images of 188 consecutive AP cases were retrospectively studied, and the morphology, density, and thickness of the edematous band in the left subphrenic region were observed. CT images of the left subphrenic region of 50 normal individual, 30 cases with pleural effusion, and 30 cases with ascites were also observed as control groups. Results LSFI appeared as a diffusive or focal crescent edematous band of soft tissue density superior to the left adrenal gland, laying just anterior to the inferior surface of left diaphragm, with or without a layer of normal fat tissue anteriorly. The incidence of the LSFI in AP was about 40.96%. Thickness of LSFI ranges from 3mm to 50 mm, with the mean value of 8 mm. In the 110 cases of the control group, only 1 case demonstrated a sign that was somewhat similar to LSFI, though it was still easily distinguished from it. Conclusion LSFI is a sign of CT manifestations of AP, it changes while AP develops, and disappears after recovery in most cases, or remains as fibrotic change in some cases.